Cisplatin is a platinum-containing chemotherapy agent used to treat many types of cancer. Originally discovered in 1965, cisplatin is now manufactured by many companies and is also used to treat myeloma, alone or in combination with other therapies.
How does cisplatin work?
Myeloma is a type of cancer affecting the blood cells. It starts in the bone marrow, where blood cells are made. The cancerous cells often appear in multiple patches in the bone marrow, so the disease is often called multiple myeloma. The cancerous cells divide rapidly and inappropriately express large quantities of proteins. For example, they produce abnormal antibodies that attack normal tissues or interfere with the normal function of the immune system.
The mechanism by which cisplatin affects cancerous cells is not completely clear but it is known that the treatment affects multiple cellular pathways. For example, it reacts with other cellular components to increase reactive oxygen species that are harmful to DNA and proteins. Cisplatin also cross-links bases in the DNA molecule, which causes gene sequences to be misread and blocks DNA repair mechanisms in the cell. The combination of these effects causes cells to die. Because cancer cells divide more rapidly than most other cell types, they are more sensitive to chemotherapy agents such as cisplatin.
Cisplatin in clinical trials
Cisplatin with dexamethasone, cyclophosphamide, and etoposide (a combination also known as DCEP) was shown to be effective in treating patients with relapsed or refractory multiple myeloma. The study involved 12 patients who had failed four to six cycles of other chemotherapy regimens. Seven of the 12 patients were candidates for autologous hematopoietic stem cell transplantation (AHSCT) therapy.
Each therapy cycle consisted of cyclophosphamide, cisplatin, and etoposide daily as a 24-hour infusion. All three therapies were administered on days 1 through 4 of the 28-day treatment cycle. Dexamethasone was also given on days 1 to 4. The cisplatin dosage was adjusted in cases where a reduction in kidney function was observed. A growth factor (an essential preparation for AHSCT) was administered from day 5 until recovery. The treatment course was repeated every 28 days.
The results of the study were published in the Journal of the Balkan Union of Oncology. They showed that the treatment combination was well-tolerated. After two cycles, two of the 12 patients achieved complete remission, five showed partial remission, and the remaining five showed no response. The overall response rate was 58.3%. Four patients went on to successful AHSCT therapy.
Side effects of cisplatin include joint pain, loss of balance, fatigue, hearing loss, seizures, swelling in the legs, muscle cramps, fever, hoarse throat, and unusual bruising. Cisplatin can also cause serious kidney dysfunction.
Last updated: Feb. 25, 2020
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